IMR Press / CEOG / Volume 46 / Issue 2 / DOI: 10.12891/ceog4525.2019
Open Access Review
Vault prolapse occurrence after total laparoscopic hysterectomy and total abdominal hysterectomy performed for benign indications, is there a difference? A systematic review of the literature
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1 2nd University Department of Obstetrics and Gynecology, Hippokratio Hospital of Thessaloniki, School of Medicine Aristotle University, Thessaloniki, Greece
2 Department of Obstetrics and Gynecology, Egemed Hospital, Ayd?n, Turkey;
3 1st University Department of Obstetrics and Gynecology, Papageorgiou Hospital of Thessaloniki, School of Medicine Aristotle University, Thessaloniki, Greece
4 University Department of Obstetrics and Gyaecology, Policlinico Hospital of Monserato, Cagliari, Italy
Clin. Exp. Obstet. Gynecol. 2019, 46(2), 183–185; https://doi.org/10.12891/ceog4525.2019
Published: 10 April 2019
Abstract

Aim: To systematically review published data on vault prolapse occurrence after total laparoscopic hysterectomy versus abdominal hysterectomy for benign uterine pathology. Materials and Methods: Medline and PubMed were searched for clinical studies reporting on vault prolapse occurrence after laparoscopic or abdominal hysterectomy. The studies included were randomized and non-randomized clinical trials reporting on the occurrence of vaginal vault prolapse as a long-term complication of either abdominal or laparoscopic hysterectomy for nonmalignant conditions. Results: The search yielded only one study reporting on vaginal cuff prolapse after laparoscopic assisted vaginal hysterectomy (LAVH) or total abdominal hysterectomy (TAH). The additional articles that were retrieved using the ‘search for related articles’ function as well as from references of eligible studies were 581. Of these, 473 studies were excluded by title, 45 by abstract, 32 by full text, seven for which the full text could not be retrieved, and 24 by language. For this study two groups of women were followed up after LAVH (n=150) and TAH (n=146). No statistically significant difference in the likelihood of vault prolapse was revealed between the two groups (p = 0.592).Conclusion: In the literature, various measures are recommended to avoid vaginal vault prolapse such as the suspension of the vaginal apex to the cardinal and uterosacral ligament or to the sacrospinous ligaments at the time of hysterectomy. More studies are needed with a greater number of cases and longer follow up to assess whether abdominal or laparoscopic hysterectomy is more appropriate to prevent vaginal vault prolapse.

Keywords
Prolapse
Laparoscopy
Total hysterectomy
Abdominal hysterectomy
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